[Surgery of hydatid cysts of the liver: 581 patients, 952 cysts].

Over a period of 20 years, surgery was carried out in 581 patients for 952 hydatid cysts of the liver. Patients included 372 females and 209 males, aged from 6 to 70 years, with a mean age of 34 years. 52% of patients were aged between 20 and 40 years. The cyst was single in 324 patients, double in 102, triple in 22 and multiple in 133. Treatment most often consisted of resection of the projecting dome of the cyst (78%), and more rarely pericystectomy (5.5%), hepatic resection (3.5%) or external drainage (4.2%) via a median incision in 412 cases and a subcostal incision in 126 cases. Capitonnage of the residual cavity was combined with resection of the projecting dome, 176 cases included a cystobiliary fistula with migration occurring in 30 cases. Morbidity was 20% and included, in particular, 45 cases of subphrenic abscess. 19 patients showed signs of recurrence and 16 underwent further surgery. Overall mortality was 2.06% i.e. 12 patients. In endemic countries, resection of the projecting dome remains a method which gives good results and has a low mortality and morbidity.